Scoliosis Symptoms and Diagnosis

Since scoliosis usually isn’t painful, it can go undetected until there are obvious, visible signs that can include:

  • A curved spine that looks like an “S” or “C,” rather than a straight line down the back.
  • Tilted, uneven shoulders, with one shoulder blade that sticks out more than the other.
  • Prominence of the ribs on one side.
  • Uneven waistline.
  • One hip that is higher than the other.
  • Twisted (also known as oblique) pelvis.
  • Signs of an underlying spinal defect, including light-brown birthmarks (also known as café au lait spots), hairy patches, dimples and spinal masses on the skin.
  • Unequal distances between the arms and sides of the body when a child stands upright or bends forward.

Learn more about the types and causes of scoliosis.

Risk Factors

Idiopathic scoliosis tends to run in families and is usually discovered when a child is 10 to 15 years old. Children and teens who have a family history of spine problems should receive regular checkups from their primary care providers to check for scoliosis.

Boys and girls are equally likely to develop scoliosis; however, girls are more likely to have larger curves or curves that will progress. If curves in the spine are going to progress, they often do so during growth spurts.

On average, girls start their peak growth spurt at 11.5 years of age; it lasts about 24 to 36 months, until the spine stops growing. It’s important to identify potentially troublesome curves at this point, before the spine fully develops.

Larger curves require monitoring and possible treatment with bracing or surgery. Scoliosis affects 2 to 3 percent of people in the U.S.

Tests and Diagnosis

Left untreated, scoliosis can worsen. In addition to curving, the spine can begin to rotate, contributing to diminished lung capacity and heart problems. Early detection increases the likelihood that your child’s scoliosis can be managed without surgery. 

A physical exam is a common way to look for idiopathic scoliosis. During an exam, a health care provider might:

  • Look for spinal deformities by asking your child to bend forward 90 degrees at the waist, with feet together, knees straight, and arms hanging free. Sometimes a tool called a scoliometer is used to measure spinal asymmetry.
  • Check to see if hips are level and shoulders are level while your child is standing upright.
  • Look for limb-length discrepancies.

Although scoliosis screening isn’t required statewide, many schools conduct scheduled screenings. School nurses may screen girls in fifth and sixth grade. A positive school screening doesn’t necessarily result in a scoliosis diagnosis; however, you might be referred to see a health care provider.

If your child shows signs of scoliosis, you should schedule a formal evaluation from an expert in childhood spine deformities. During a formal evaluation by a qualified specialist, your child might have imaging tests like X-rays or an MRI to get detailed information about your child’s back.

Gillette Children’s Specialty Healthcare offers comprehensive scoliosis evaluations, treatments and services for all ages—from infants to adults. At Gillette, you’ll work with leading pediatric experts in treating scoliosis.